Edmonston, Tina B.

Edmonston, Tina B. is an individual health care provider with primary practice located at 200 Federal St Suite 437, Camden NJ 08103-1061. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Molecular Genetic Pathology, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is her primary health care specialty. Edmonston, Tina B. can be contacted via phone (856) 963-0573.

Contact Information

Primary practice address
200 Federal St Suite 437 Camden NJ 08103-1061
Phone: (856) 963-0573
Fax: (856) 541-6037
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Molecular Genetic Pathology 207ZP0007X MD421051 Pennsylvania
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X MD421051 Pennsylvania

Profile Details

NPI number 1679581284
LBN Legal business name Edmonston, Tina B.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2006
Last updated Sep 27th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679581284 NPPES
Pennsylvania MEDICAID 101103749
Pennsylvania MEDICAID 0043141

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